Locations
Kartini Clinic
Portland, OR
My office hours
Thursday: 8:00am - 5:00am
Show morePhone
Practice website
Insurances accepted
No Value
Aetna Life Insurance Company
Blue Cross of California
About
Bio
I am the founder and medical director of Kartini Clinic
SpecialtiesDoctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Doctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Pediatrics
Languages spoken
German
Doctor Q&A
56 Answers
5 Agrees
The number of answers this doctor has agreed with.
A 50-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Increased risk: Several studies have shown that a person who has a first degree relative (parent, child, sibling) with anorexia nervosa has about a tenfold greater ch... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 34-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
It always does: Anorexia nervosa is an illness with a mortality rate (death rate) of around 10%, with half of these deaths being from suicide. How could such a thing... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 38-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
It varies: We have seen teens whose anorexia is of long standing (years) and has gone unrecognized because doctors and families tend to minimize weight loss in t... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
We aren't sure: The answer is probably not as simple as every one is eating too much and exercising too little, although these things can contribute heavily. Not all... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsAnswered >2 years ago
A 43-year-old female asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
State not weight: At kartini clinic we tell our young adult patients that we are headed for a "state" not weight, and this would equally apply to an older adult woman. ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Cause is unknown: No one knows, really. But two things we do know: parents do not cause anorexia nervosa in children and children do not choose to have it.
Basically, ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 37-year-old female asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Yes: Ed's are not intentional, any more than diabetes is. Please do not let people blame you for these terrible illnesses which torture the sufferers.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsAnswered >2 years ago
A 43-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Yes: Yes, but not without complete weight restoration.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 43-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
The brain: Lack of emotion, or dysregulated emotion, occurs frequently when the brain has been starved. If the starvation is of long enough duration, apathy and... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 32-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
No one knows: The science is simply not there yet. To date an appears to be a highly heritable brain disorder of unknown cause. We do know, however that parents d... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Prevent worsening: It is critical that you get immediate help to prevent a further worsening of your symptoms. Make yourself accountable to your family and to your doct... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 34-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Genetics: As far as we can tell, there is a strong heritability component to the vulnerability for eating disorders. It is at any rate clear that parents do no... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 34-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Drink less water: Bloating is made much worse by drinking large amounts of water with meals as it increases a hormone (cck), triggered by the stretch receptors of the s... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 44-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Two different things: Weight restoration, while not everything, is the first, critical step towards recovery. No psychological processing/healing is possible if a patient r... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
It depends on age: It depends on the patient's age. Children with an may present completely differently than adults. An early sign would be social isolation.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsAnswered >2 years ago
A 29-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
More please: What do you mean "regular foods"? Are you craving only sweets or odd food combinations? Are you able to maintain your weight? You may have an eatin... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 35-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
It depends on age: The best places for pediatric care are not the same as the best places for adult care and ideally their care should not be mixed. The best care shoul... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 37-year-old female asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Yes: Any chronic illness that affects appetite or metabolic rate can cause weight loss. The word "anorexia" just means loss of appetite, in medical-speak,... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 32-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Sometimes: If you mean anorexia nervosa, many people with an complain of fullness, nausea and discomfort eating meals.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 46-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Absolutely: At kartini clinic we see children as young as seven with eating disorders, in this case anorexia nervosa.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 31-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
It's a technicality: The diagnosis ednos just means that the patient doesn't fit neatly into a dsm-iv diagnostic category, it has little real meaning as the symptoms are t... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 37-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Age dependent: A great deal depends on the age of the patient. Children and adolescents will often present with social withdrawal as their first symptom, followed ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 43-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
All ED's are serious: If you mean anorexia nervosa, it has a lifetime mortality (death) rate of 10%--that's serious. If you mean bulimia nervosa and binge eating disorder-... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 45-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Other problems?: How would you answer this question if someone asked "my boyfriend has diabetes--stay or go?"
people do not choose eating disorders, they are illnesse... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 31-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Stop resticting: In our experience, binge eating can be fueled by many things, but two common ones would be:
1. Restricting food intake when not bingeing, especially ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsAnswered >2 years ago
A 36-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Probably not: No one really knows what causes these highly heritable brain disorders. But certainly bereavement can cause all kinds of life disruptions, including ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 39-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Absolutely!: You need help and you need help from people who will not shame you, regardless of your size.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsAnswered >2 years ago
A 48-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
You live there: Residential treatment just means you live at the treatment center without your family.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 45-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Absolutely!: Because of a condition called anosognosia (where the brain does not recognize that it has a problem), it is not uncommon for people to say they don't ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsAnswered >2 years ago
A 40-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Yes: Anorexia nervosa is just like any other serious human illness-- your grandmother may suspect the diagnosis of whatever it is, but it would be a good i... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Absolutely: If you have an eating disorder you may have poor bone health including stress fractures or osteopenia; your trainer also needs to know whether or not ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.1k viewsAnswered >2 years ago
A 25-year-old female asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
They aren't: I am impressed by how infrequently patients show signs of anemia and hypo-proteinemia (low protein) even when at a very low weight. It underscores th... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
I : I am a pediatric eating disorder physician and i would like to go on record as saying that obesity is not child abuse. Frankly we understand so littl... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.3k viewsReviewed >2 years ago
A 33-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Please don't try: Because of the serious nature of this illness and because of the profound medical and psychological as well as social ramifications that it can have, ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsAnswered >2 years ago
A 20-year-old female asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
We have one: At kartini clinic we have a meal plan that helps children, adolescents and young adults recover from their eating disorder, whether that be anorexia n... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
I : I am a pediatric eating disorder specialist and although we only treat patients to age 21 or so at the kartini clinic in portland oregon, we do someti... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.3k viewsReviewed >2 years ago
A 44-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
The brain: Lack of emotion, or dysregulated emotion, occurs frequently when the brain has been starved. If the starvation is of long enough duration, apathy and... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 47-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Be careful: Do not confuse binge eating disorder with obesity, the rates for which are very high. Most people with obesity do not have binge eating disorder.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Weight restoration : I have seen even impressive cases of lanugo (which can be dark) go away completely with adequate weight restoration. If you do not become weight rest... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 35-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Parents do not cause eating disorders: Eating disorders are not caused by modeling behavior or by the media. They are brain disorders of unknown etiology (cause) which do run in families (... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.1k viewsAnswered >2 years ago
A 41-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Your mom is human: The same way you would tell if anyone has binge eating disorder---do they binge? If so, assume she is humiliated and ashamed of her behavior and act ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 39-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
It is likely: Osteoporosis and osteopenia (weak bones) are common side effects of weight loss and lack of periods. Birth control pills do not help. If you are und... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 46-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Depends on diagnosis: If you mean for anorexia nervosa, the best and most important way to recover is to achieve weight restoration.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
It can look like it: Although a patient with an can look like they are trying to kill themselves, this is rarely their motivation. Many adult patients will tell you, if a... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 32-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Same as for females: Boys get anorexia too! we have male patients as young as 9-10 and although boys may express themselves differently than girls, the illness, the brain... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 47-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Accept weight gain: Weight restoration, while not everything, is the first, critical step towards recovery. No psychological processing/healing is possible if a patient ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 46-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
They are many: 1. Social isolation
2. Preoccupation with food and calories and fat in food
3. Weight loss
4. Angry response to questions about eating more
5. Exc... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsAnswered >2 years ago
A 42-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Yes: If you get an eating disorder before your body has time to menstruate, it most certainly can delay the start.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Depends on hospital: You should make every attempt to be treated at a hospital where the providers make this their specialty. A medical doctor should make rounds on you e... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. Julie O'Tooleanswered
Pediatrics 38 years experience
Absolutely!: Even people with anorexia nervosa may go through periods of normal weight or higher than normal weight, and their diagnosis is still anorexia nervosa.
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
TestimonialsRecommendations and Thank you notes are endorsements given from patients or other doctors.
Recommendations and Thank you notes are endorsements given from patients or other doctors.
2
Recommendations
92
Thank you notes
HealthTap member
Mar 30, 2015
Dr. O'Toole is an amazing doctor! #nationaldoctorsday2015 #virtualflower1
HealthTap member
Mar 31, 2015
Dr. O'Toole is an amazing doctor! #nationaldoctorsday2015 #virtualflower1
HealthTap member
Thank you, your answer was very helpful! I have had an eating disorder for over 20 years and have a partner who loves me regardless and is never an enabler.
HealthTap member
Thank you, your answer was very helpful!
HealthTap member
Thank you, your answer was very helpful!
Education & Training
Medical/Graduate school
Rheinisch-Westfalische Technical Academy at Aachen, Germany
Graduated 1980MD
Medical/Graduate school
University of Hawaii School of Public Health MPH
Graduated 1985MD
Residency
Kapiolani Medical Center For Women & Children
Residency
Providence Sacred Heart Medical Center
Awards
Top Doctors, Portland Monthly Magazine
Top Pediatrician, First Place, Oregon - Summer
2013
Affiliations
Randall Children's Hospital Portland, Oregon
Publications
Children and Adolescents with Eating Disorders: the State of the Art.
In Search of PANDAS (Pediatric Autoimmune Neuro-endocrine Disorder Associated with Streptoccocus): a Spotter’s Guide
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